Setting new standards in mental health

The revised Mental Health Act Code of Practice has been welcomed by doctors, psychiatrists and other health professionals. But is it enough? Or is it time to revise the Act itself?

"We are confident we have succeeded in producing a revised Code which meets the needs of patients, families, carers and professionals," says Health Secretary Jeremy Hunt in his foreword to the new Mental Health Act Code of Practice, which came into effect on 1 April 2015. The clarification of roles, rights and responsibilities will surely be seen as a step forward for all those who work in the mental health sector, from psychiatrists, psychologists and psychotherapists to frontline mental health nurses. It has also been welcomed by Professor Sir Mike Richards, Chief Inspector of Hospitals, who has said it will ‘strengthen and support’ the work of the Care Quality Commission.

However, doubts have been expressed about whether a new Code of Practice is enough. For example, Mental Health Alliance Chair Suzanne Hudson has questioned the integrity of the legislation itself. Quoted on the website of leading mental health charity Mind, she commented, "Guidance can only go as far as the legislation allows, and the Act itself is outdated, discriminatory and requires significant review."

The Government consulted widely on the revised code and received almost 350 responses, including detailed submissions from the Royal College of Psychiatrists, the British Psychological Society (representing over 50,000 psychologists and other mental health professionals across the UK) and, giving the perspective of mental health nurses, the Royal College of Nursing. A 'consultation response' document, Stronger Code: Better Care, was published by the Department of Health in January 2015.

The new Code puts greater emphasis on involving patients, families and carers in the decision-making process. It also updates guidance on complaints, safeguarding, human rights issues, Deprivation of Liberty Safeguards (DoLS), police powers, safe and therapeutic responses to behavioural disturbances, and care planning. For the first time, it sets out duties towards people detained under immigration legislation who are moved to hospital under the Mental Health Act.

As for updating the legislation itself, according to Ms Hudson that's a challenge for the winners at the ballot box on 7 May: "Whoever forms the next government must review the current legislation and ensure sufficient investment in mental health services to end the disparity between physical and mental health care."

Are you a mental health professional, such as a psychiatrist, psychologist, psychotherapist or mental health nurse, with views on the issues raised in this article? Leave your comments below.